CN-370000-HW561-DC01GCO9.pdf
PDF 319 KB Posted
- Contract number
- HW561
- Issued by
- Florida
About this file
This document comprises Task Assignment Notification Change Order Forms under DEP Contract No. HW561 between the Florida Department of Environmental Protection (DEP) and Golder Associates, Inc. (Golder), with Matt Crews serving as the contractor representative and Ben Grubbs as the DEP Contract Manager. The site designation is "Critical Response" with no specific facility ID assigned. The forms represent Change Orders 8 and 9 issued to the task assignment DC001G.
The task involves documentation and critical response services related to environmental site activities, specifically including air monitoring reports, site visit letters, offsite notification packages, system shutdown and restart documentation for tropical storms and hurricanes (Hermine and Irma), and assessments at fuel service stations in Putnam County. The fixed price task amount remains constant at $18,692.60 across both change orders, with no net increase or decrease in compensation. Change Order 8 extended the completion date from June 28, 2021 to December 28, 2021 (a 6-month extension), while Change Order 9 further extended completion to April 29, 2022 (an additional 122 days). Both change orders were authorized as time extensions to maintain the task assignment's open status for potential critical response activities. The invoice schedule itemizes seven deliverables previously invoiced totaling $16,192.60, with the final deliverable of "Documentation of completed site activities" valued at $2,500.00, bringing the total cost to $18,692.60.
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Text version
DEP CONTRACT NO.
Task Assignment #: Change Order No.:
Contractor Name:
Contractor Representative:
DEP Contract Manager: Phone #:
Site Name:
Site ID / Facility ID::
Description of Change [use additional pages if necessary]:
The Deliverable and Invoice Schedule is attached.
Final Deliverable:
TASK ASSIGNMENT TYPE AND NOT TO EXCEED AMOUNTS:
Cost Reimbursement Fixed Fee
Original Task Amount
Task Amount Prior to this Change Order Net Increase/decrease in task amount Task amount with all change orders $0.00 $0.00 $0.00 $0.00
Original Task Completion Date:
Completion Date Prior to this Change:
Net Increase/Decrease in Task Period:
Completion Date with all Change Orders:
DEP Task Manager:
DEP Contract Manager:
Contractual Authority:
Contractor Representative:
CC: Procurement Section (MS 93) Section Representative ________
FIXED PRICE
TASK ASSIGNMENT NOTIFICATION CHANGE ORDER FORM
ITEM
$0.00
$0.00
DEP will review the deliverables to verify that they meet the specifications of this contract and task description. DEP’s Contract Manager shall notify the Contractor of any deficiencies in the deliverable(s) and shall give the Contractor reasonable opportunity to correct noted deficiencies and provide a revised deliverable(s).
Final Deliverable Due Date:
$0.00
$0.00
CHANGE IN TASK TIME
FEE SCHEDULE
COST PLUS FIXED FEE
TOTAL
WCP TAFORM 01_18
HW561
9DC001G
Golder Associates, Inc. (Golder)
Matt Crews
(850) 245-8992Ben Grubbs
Critical Response
NA
This Task Assignment Change Order authorizes a time extension to keep this Task Assignment open should critical response activities be warranted.
Documentation of completed site activities 04/29/2022
$ 2,500.00 $ 0.00 $ 0.00 $ 0.00
$ 18,692.60 $ 0.00 $ 0.00 $ 0.00 $ 18,692.60
$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00
$ 18,692.60
12/28/2020
12/28/2021
122 days
04/29/2022
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2021.12.10 09:17:05 -05'00'
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2021.12.10 09:17:15 -05'00'
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2021.12.10 09:39:29 -05'00'
Donald Miller Digitally signed by Donald Miller Date: 2021.12.13 08:45:31 -05'00'
$ 18,692.60 $ 0.00 $ 0.00 $ 0.00
$ 2,500.00
Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment
Contract Number: HW561 Task Assignment #: DC001G
Change Order #: 9
Deliverables:
Deliverable Deliverable Due Date Air Monitoring Report Completed
Site Visit Letter Report Completed
Offsite notification packages Completed
Email documentation of System Shutdown and Restart Completed
Documentation of SVE systems shutdown for Hurricane Hermine Completed
Documentation of completed site activities 29-Apr-22
Documentation of SVE systems shutdown and restart for Hurricane Irma
Completed
Documentation of assessment at fuel service stations in Putnam County
Completed
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced DEP approval of Air Monitoring Report - Previously Invoiced
$1,527.18
DEP approval of Site Visit Letter Report and Offsite Notification Package - Previously Invoiced $6,673.16
DEP approval of Tropical Storm System Shutdown and Restart - Previously Invoiced $637.65
DEP approval of SVE Systems shutdown for Hurricane Hermine - Previously Invoiced $273.62
DEP approval of Documentation of completed site activities $2,500.00
DEP approval of Documentation of SVE systems shutdown and restart for Hurricane Irma - Previously Invoiced $1,927.59
DEP approval of Documentation of assessment at fuel service stations in Putnam County - Previously Invoiced $5,153.40
TOTAL COST $18,692.60
BWC TAFORM 01_18
DEP CONTRACT NO.
Task Assignment #: Change Order No.:
Contractor Name:
Contractor Representative:
DEP Contract Manager: Phone #:
Site Name:
Site ID / Facility ID::
Description of Change [use additional pages if necessary]:
The Deliverable and Invoice Schedule is attached.
Final Deliverable:
TASK ASSIGNMENT TYPE AND NOT TO EXCEED AMOUNTS:
Cost Reimbursement Fixed Fee
Original Task Amount
Task Amount Prior to this Change Order Net Increase/decrease in task amount Task amount with all change orders $0.00 $0.00 $0.00 $0.00
Original Task Completion Date:
Completion Date Prior to this Change:
Net Increase/Decrease in Task Period:
Completion Date with all Change Orders:
DEP Task Manager:
DEP Contract Manager:
Contractual Authority:
Contractor Representative:
CC: Procurement Section (MS 93) Section Representative ________
FIXED PRICE
TASK ASSIGNMENT NOTIFICATION CHANGE ORDER FORM
ITEM
$0.00
$0.00
DEP will review the deliverables to verify that they meet the specifications of this contract and task description. DEP’s Contract Manager shall notify the Contractor of any deficiencies in the deliverable(s) and shall give the Contractor reasonable opportunity to correct noted deficiencies and provide a revised deliverable(s).
Final Deliverable Due Date:
$0.00
$0.00
CHANGE IN TASK TIME
FEE SCHEDULE
COST PLUS FIXED FEE
TOTAL
WCP TAFORM 01_18
HW561
8DC001G
Golder Associates Matt Crews
(850) 245-8992Ben Grubbs Critical Response
NA
This Task Assignment Change Order authorizes a time extension to keep this Task Assignment open should critical response activities be warranted.
Documentation of completed site activities 12/28/2021
$ 2,500.00 $ 0.00 $ 0.00 $ 0.00
$ 18,692.60 $ 0.00 $ 0.00 $ 0.00 $ 18,692.60
$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00
$ 18,692.60
12/28/2020
06/28/2021
6 months
12/28/2021
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2021.05.25 14:16:01 -04'00'
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2021.05.25 14:16:11 -04'00'
William Burns Digitally signed by William Burns Date: 2021.05.25 14:57:29 -04'00'
Donald Miller Digitally signed by Donald Miller Date: 2021.05.25 16:08:04 -04'00'
$ 18,692.60 $ 0.00 $ 0.00 $ 0.00
$ 2,500.00
Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment
Contract Number: HW561 Task Assignment #: DC001G
Change Order #:
Deliverables:
Deliverable Deliverable Due Date Air Monitoring Report Completed
Site Visit Letter Report Completed
Offsite notification packages Completed
Email documentation of System Shutdown and Restart Completed
Documentation of SVE systems shutdown for Hurricane Hermine Completed
Documentation of completed site activities 28- -21
Documentation of SVE systems shutdown and restart for Hurricane Irma
Completed
Documentation of assessment at fuel service stations in Putnam County
Completed
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced DEP approval of Air Monitoring Report - Previously Invoiced
$1,527.18
DEP approval of Site Visit Letter Report and Offsite Notification Package - Previously Invoiced $6,673.16
DEP approval of Tropical Storm System Shutdown and Restart - Previously Invoiced $637.65
DEP approval of SVE Systems shutdown for Hurricane Hermine - Previously Invoiced $273.62
DEP approval of Documentation of completed site activities $2,500.00
DEP approval of Documentation of SVE systems shutdown and restart for Hurricane Irma - Previously Invoiced $1,927.59
DEP approval of Documentation of assessment at fuel service stations in Putnam County - Previously Invoiced $5,153.40
TOTAL COST $18,692.60
BWC TAFORM 01_18
| Task Assignment CHANGE ORDER |
| BWC Task Assignment Change Order Form (Rev 02-17).pdf |
| Task Assignment CHANGE ORDER |
| BWC Task Assignment Form - Page 2 (Rev 08_10) - Rev 1.pdf |
| Deliverable & Invoice Schedule |
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